7 sick: Not just a UK problem: Outbreak of Campylobacter jejuni associated with consuming undercooked chicken liver mousse

The U.S. Centers for Disease Control reports that on July 13, 2016, Clark County (Washington) Public Health (CCPH) received a report of diarrheal illness in four of seven members of a single party who dined at a local restaurant on July 6, 2016. The report was received through an online/telephone system for reporting food service–associated illness complaints. Members of the five households in the party reported that their only shared exposure was the restaurant meal. CCPH ordered closure of the restaurant kitchen on July 13, 2016, and began an investigation to identify the source of diarrheal illness and implement additional control measures.

CCPH defined a probable case of restaurant-associated illness as diarrhea lasting >2 days in any restaurant guest or staff member with illness onset from July 1, 2016, to July 23, 2016. After Campylobacter jejuni was cultured from stool specimens submitted by three ill members of the dining party, a confirmed case was defined as culture evidence of C. jejuni infection in any restaurant guest or staff member with onset of diarrheal illness during the same period. Five cases (three confirmed and two probable) were identified, four in restaurant guests and one in a food worker; patient age ranged from 27–46 years; three patients were female.

CCPH conducted a case-control study involving 28 menu items, using 14 non-ill dining companions and restaurant staff members as controls. Consumption of two menu items, chicken liver mousse (odds ratio [OR] = 36.1, 95% confidence interval [CI] = 1.58–828.9), and grilled romaine hearts (OR = 18, 95% CI = 1.19–271.5) were associated with case status. Because of the higher odds ratio of chicken liver mousse and previous Campylobacter outbreaks associated with chicken livers (1,2), the investigation focused on the mousse.

During an inspection on July 15, the sous-chef solely responsible for preparing the chicken liver mousse demonstrated preparation to the CCPH food safety inspector, who observed that the sous-chef used the appearance of the livers alone to determine whether they were fully cooked. Final internal cook temperature of the largest liver measured by the inspector was <130°F (54°C), below the minimum 165°F (74°C) internal temperature deemed necessary by the Food and Drug Administration to eliminate food safety hazards (3). Because raw chicken parts are not required to be free of Campylobacter (4), and the bacteria might be present on the surface of 77% of retail chicken livers (5), CCPH immediately addressed undercooking of the livers.

One patient stool specimen isolate was available for typing by pulsed-field gel electrophoresis (PFGE). The PFGE pattern from this isolate was indistinguishable from those obtained from two chicken liver samples collected in a 2014 campylobacteriosis outbreak in Oregon (1). Chicken livers associated with both the 2014 outbreak and with this outbreak were supplied by the same company. Chicken livers from the lot served at the restaurant on the day of the implicated meal were no longer available; therefore, the U.S. Department of Agriculture could not pursue testing of chicken liver samples.

Among published C. jejuni outbreaks associated with undercooked chicken livers, this outbreak report is the second from the Pacific Northwest (1), and the first in the United States initially reported through an illness complaint system. Because CCPH does not actively investigate Campylobacter cases in persons aged >5 years, and because Campylobacter PFGE is not routinely conducted in Washington, this outbreak would have likely gone undetected if not for the illness complaint system, demonstrating the value of illness complaint investigations to identify outbreaks and mitigate public health risks.

NZ campy outbreak cost $21m

In Aug. 2016, some 5,500 people in a New Zealand town of 14,000 were sickened with Campylobacter linked to the water supply and three died.

Didn’t chlorinate.

Eric Frykberg of RadioNZ reports the NZ Ministry of Health has found Havelock North’s water contamination cost about $21 million – with residents the worst affected.

The campylobacter infection hit the town last August and afflicted more than 5,000 people with illness, filling the hospital and potentially contributing to three deaths.

The investigators measured the next best thing that people could have been doing if they had not been sick. That and the value of direct costs added up to the total figure of $21,029,288.

A report commissioned by the ministry said some 5088 households were affected by the crisis, and the cost to each household was about $2440.

Those costs included the cost of people getting sick and being unable to go to work or school or carry out other tasks.

Some were unable to look after their children, while others had to drive all over town to visit doctors or to get fresh water or other supplies.

They also had to do far more laundry and cleaning.

This left the households to foot a bill of more than $12,420,000 making up the majority of all costs from the crisis.

The report also said not all consequences of the outbreak could be quantified in monetary terms, with personal stress, loss of public faith in the water supply, and “scarring” of the community adding to the societal bill.

The report said about 25 percent of the population of Havelock North was aged over 65 based on the 2013 Census, and the town also had a large number of school aged children.

Fancy food ain’t safe food, Mark Sergeant’s Rocksalt edition

An award-winning Folkestone, UK, restaurant run by celebrity chef Mark Sergeant has been given a low food hygiene rating.

Inspectors discovered ‘unsafe’ cooking procedures at Rocksalt, in Folkestone Harbour and the top eatery was told ‘improvement is necessary’.

Callum Wilson of Kent Live reports the damning Environmental Health report, inspectors said diners were at risk of food poisoning.

The restaurant, which has previously received rave reviews, has now had its five star rating taken away and replaced with the much lower rating ‘requires improvement’.

A Shepway District Council environmental health officer took the perfect score away after finding a ‘high risk’ chicken liver was undercooked.

The officer said: “I noted some cooking procedures that could lead to an unsafe product. For example: chicken livers maybe cooked “medium”.

“Chicken liver pate is cooked in the combi-oven. Core temperature is monitored using a probe and the product is considered cooked when it reaches 70 C.

“The time temperature combination for thorough cooking is 70C held for 2 minutes.”

In a warning to the restaurant, the officer said: “Please ensure chicken products are thoroughly cooked (as per your HACCP procedure for high risk products)”.

Rocksalt is co-owned by celebrity chef Mark Sargeant and Josh DeHaan and opened in 2011.

No one at the restaurant was available for comment.

However, a post appeared on the Rocksalt website saying: “We have requested a revisit and have addressed the single cooking technique deemed incorrect.

“We have urgently retrained all staff to our correct procedure.”

39 sick: You’re a cute puppy, yes you are, but you have Campylobacter

The Ohio Department of Health, several other states, the U.S. Centers for Disease Control, and USDA-APHIS are investigating a multistate outbreak of human Campylobacter infections linked to puppies sold through Petland stores.

Investigators are looking for the source of infections in people and puppies so they can recommend how to stop the outbreak and prevent more illnesses in order to protect human and animal health.

As of September 11, 2017, the outbreak includes 39 cases in 7 states (Florida, Kansas, Missouri, Ohio, Pennsylvania, Tennessee, and Wisconsin).

Illnesses began on dates ranging from September 15, 2016 through August 12, 2017. The most recent illness was reported on September 1, 2017.

Ill people range in age from <1 year to 64 years, with a median age of 22 years; 28 (72%) are female; and 9 (23%) report being hospitalized. No deaths have been reported.

Epidemiologic and laboratory findings have linked the outbreak to contact with puppies sold through Petland stores. Among the 39 ill people, 12 are Petland employees from 4 states and 27 either recently purchased a puppy at Petland, visited a Petland, or visited or live in a home with a puppy sold through Petland before illness began.

Whole genome sequencing showed samples of Campylobacter isolated from the stool of puppies sold through Petland in Florida were closely related to Campylobacter isolated from the stool of an ill person in Ohio. Additional laboratory results from people and dogs are pending.

Regardless of where they are from, any puppies and dogs may carry Campylobacter germs.

 

Raw milk is risky

I have friends who grew up on the farm their entire lives and insist on drinking raw milk as they feel that pasteurization completing devoid the milk of nutrients. I can preach about the dangers of consuming raw milk supported with scientific facts but that’s not going to change their minds. They’re adults, they can make their own choices; just don’t impose your choice on a child. When I was younger I was courting a girl who lived on a dairy farm in rural Manitoba (Canada). She insisted on drinking raw milk and offered some to me. I was aware that raw milk was risky but this way before my food safety days. So like many boys courting women, you sometimes make foolish mistakes and so I drank the milk. Puked it up. Not because of microbial reasons, just tasted horrible, maybe it was that batch, not sure.

Kristi Rosa reports
The Centers for Disease Control and Prevention (CDC) have issued an official health advisory regarding a rifampin/penicillin-resistant strain of RB51 Brucella that has been linked with the consumption of raw milk; this follows a alert issued by the Texas Department of State Health Services (DSHS) that was issued back in mid-August.

The DSHS defines raw milk as “milk from cows or other animals that has not been pasteurized to kill harmful bacteria.” Raw milk can be contaminated with several different bacteria, including Listeria, Salmonella, Escherichia coli, and Campylobacter—all bacteria that are known to be responsible for countless disease outbreaks.

The individual who contracted brucellosis is a Texas resident who was exhibiting fever, muscle and joint pain, as well as fatigue. The DSHS reports that blood culture revealed the bacteria responsible for these symptoms was, in fact, Brucella. Further investigation tracked the infection back to a potential source: a licensed raw milk dairy based in Paradise, Texas, called K-Bar Dairy.

The CDC stresses that any individuals who have consumed raw milk from this dairy between June 1, 2017 and August 7, 2017 should “receive appropriate post-exposure prophylaxis (PEP).” These individuals are thus at increased risk for infection and should contact their healthcare providers to inquire about PEP and undergo potential diagnostic testing.

K-Bar Dairy has fully cooperated with the CDC’s investigation and has contacted customers and advised them to dispose of any milk that may be contaminated. However, the dairy does not have a record of all customers, therefore, the DSHS alerted the public about the recall on August 14, 2017.

The rest of the story can be found here.

8 sick from campy in liver parfait at UK boutique hotel

Public Health England (PHE) has revealed that chicken liver parfait was the cause of illness at Brockley Hall Hotel in Saltburn.

However “no obvious defect was noted in the production of this food item”, therefore meaning it cannot be concluded with certainty why it caused illness.

Undercooking?

A total of eight cases were reported to PHE North-east – six of which were laboratory confirmed cases of campylobacter . The two remaining cases were “probable” reports Laura Love of Gazette Live.

Most of those who fell ill had been attending a 40th birthday celebration on Friday, July 7 – with three of them being hospitalised.

This included the birthday girl herself, who ended up in hospital on a drip.

A spokeswoman for PHE said their investigation is now complete , and that a copy of the outbreak report has been sent to Redcar and Cleveland Council.

The decision on what further action, if any, to take rests with the local authority .

24 sick with campy from pig roast in Guelph

Canada’s self-proclaimed capital of food safety has reported at least 24 people became ill after attending a pig roast in Guelph earlier this year.

A report by Wellington-Dufferin-Guelph Public Health says that the people became ill with a gastrointestinal disorder after attending a catered pig roast event at an unspecified location in Guelph in May/June.

That’s some good reporting time. Guess everyone was off for summer holidays.

“Pig roasts area a popular and high-risk method of cooking for large gatherings. It is important that WDGPH staff are prepared to respond to community outbreaks and remain diligent in their knowledge of food safety,” reads a staff report.

“Pig roasts are a common catering method for preparing and cooking large volumes of meat. This cooking style is associated with a number of food safety challenges that food operators must be aware of in order to prevent any potential food borne illness from occurring in those consuming the meat.”

Leftover food from the pig roast was delivered the following morning to a drop-in centre in Guelph, but no illnesses from those consuming the meat there were reported.

A total of 82 individuals attended the event and Public Health interviewed 74 of them. Thirty-three per cent of those people reported getting sick, the report says.

“The inspection and epidemiological investigation indicate pork as the source of illness,” says the report.

An inspection of the unnamed Guelph caterer for the pig roast found “a number of items” not in compliance with regulations, including hazardous food not being maintained at 4 C or lower during transportation, poor sanitary maintenance and lack of supplies in the staff washroom.

Name and shame the caterer.

Fancy food ain’t safe food: 2 sick with campy: It was the foie gras at Seattle restaurant

I always have a thermometer in my backpack.

That’s how much of a food safety nerd I am, and why I don’t get invited to dinner parties (and, I can be an asshole).

King County Public Health investigated an outbreak of Campylobacter associated with a single meal party at Café Juanita in Kirkland on June 24, 2017.

On July 24th, Public Health learned about two ill persons from a single meal party during an interview with an ill person diagnosed with Campylobacter. We were not able to confirm illness information about the second ill person until August 16th. No other ill persons have been identified.

The ill persons shared multiple food items, including foie gras. Foie gras has been linked to other Campylobacter outbreaks in the past, particularly when eaten raw or undercooked.

Public Health’s Environmental Health inspectors visited the restaurant on August 17th. During the field inspection, inspectors observed the cooking process and checked the final cooking temperature of the foie gras. Although it reached a safe temperature during the inspection, workers had not been using a thermometer. They were instructed to use a food thermometer to ensure that all foods are reaching the correct temperatures to kill harmful bacteria that may be present. The restaurant worked cooperatively with Public Health.

Inspectors made a return visit on August 22nd and reviewed sources and preparation steps of the other foods that the two cases may have also consumed.

4 sick with campy linked to raw milk served at Royal Welsh Show

In 2013, at least 50 people, mainly children, became ill with E coli O157 at the Ekka, Queensland, Australia’s version of the state fair.

It starts again on Friday, and because organizers have done little except to encourage people to wash their hands, we won’t be going.

Handwashing is never enough.

Manure from ruminants is easily aerosolized in these environments, and I’ve been to many human-animal interaction events for research, and there is shit everywhere.

Although ostensibly designed to promote understanding of food production, these agricultural celebrations rarely discuss risk – until an outbreak happens.

The motto seems to be: It’d be better for us if you don’t understand.

Now, four people have been sickened with Campylobacter linked to unpasteurised or raw cow’s milk from Penlan y Môr farm near New Quay, Ceredigion and sold at the Royal Welsh Show.

Public Health Wales says the four cases all consumed or bought the milk at Aberystwyth Farmer’s Market after June 1.

But visitors to the Royal Welsh Show in Builth Wells may also have sampled or bought the milk which was available there on Wednesday, 26 July.

A table of animal-human-interaction outbreaks is available at http://www.barfblog.com/wp-content/uploads/2017/08/Petting-Zoo-Outbreaks-Table-7-26-17.xlsx

Erdozain G, Kukanich K, Chapman B, Powell D. 2012. Observation of public health risk behaviours, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011. Zoonoses Public Health. 2012 Jul 30. doi: 10.1111/j.1863-2378.2012.01531.x. [Epub ahead of print]

Observation of public health risk behaviors, risk communication and hand hygiene at Kansas and Missouri petting zoos – 2010-2011Outbreaks of human illness have been linked to visiting settings with animal contact throughout developed countries. This paper details an observational study of hand hygiene tool availability and recommendations; frequency of risky behavior; and, handwashing attempts by visitors in Kansas (9) and Missouri (4), U.S., petting zoos. Handwashing signs and hand hygiene stations were available at the exit of animal-contact areas in 10/13 and 8/13 petting zoos respectively. Risky behaviors were observed being performed at all petting zoos by at least one visitor. Frequently observed behaviors were: children (10/13 petting zoos) and adults (9/13 petting zoos) touching hands to face within animal-contact areas; animals licking children’s and adults’ hands (7/13 and 4/13 petting zoos, respectively); and children and adults drinking within animal-contact areas (5/13 petting zoos each). Of 574 visitors observed for hand hygiene when exiting animal-contact areas, 37% (n=214) of individuals attempted some type of hand hygiene, with male adults, female adults, and children attempting at similar rates (32%, 40%, and 37% respectively). Visitors were 4.8x more likely to wash their hands when a staff member was present within or at the exit to the animal-contact area (136/231, 59%) than when no staff member was present (78/343, 23%; p<0.001, OR=4.863, 95% C.I.=3.380-6.998). Visitors at zoos with a fence as a partial barrier to human-animal contact were 2.3x more likely to wash their hands (188/460, 40.9%) than visitors allowed to enter the animals’ yard for contact (26/114, 22.8%; p<0.001, OR= 2.339, 95% CI= 1.454-3.763). Inconsistencies existed in tool availability, signage, and supervision of animal-contact. Risk communication was poor, with few petting zoos outlining risks associated with animal-contact, or providing recommendations for precautions to be taken to reduce these risks.

Best practices for planning events encouraging human-animal interactions

Zoonoses and Public Health

G. Erdozain , K. KuKanich , B. Chapman  and D. Powell

http://onlinelibrary.wiley.com/doi/10.1111/zph.12117/abstract?deniedAccess

Educational events encouraging human–animal interaction include the risk of zoonotic disease transmission. It is estimated that 14% of all disease in the US caused by Campylobacter spp., Cryptosporidium spp., Shiga toxin-producing Escherichia coli (STEC) O157, non-O157 STECs, Listeria monocytogenes, nontyphoidal Salmonella enterica and Yersinia enterocolitica were attributable to animal contact. This article reviews best practices for organizing events where human–animal interactions are encouraged, with the objective of lowering the risk of zoonotic disease transmission.

Rare chicken hooks UK food porn-types, the country that gave the world mushy peas and mad cow disease: It’s a Salmonella/Campy shit-storm waiting to happen

Just when you thought you’d seen every possible bizarre foodie trend on Instagram, a truly stomach-churning craze comes along to surprise you.

Siofra Brennan of the Daily Mail writes people have been sharing images of their ‘juicy and tender’ meals of medium rare chicken, claiming it’s the best possible way to enjoy the meat, but their claims certainly haven’t gone down well with the masses. 

People have described the craze as ‘salmonella waiting to happen’ with one stating that there’s a ‘special place reserved in hell’ for people who don’t cook their chicken properly. 

However, fans are absolutely insistent that it’s the best way to eat the poultry with one declaring that if you’re not having your chicken medium rare, ‘you’re doing it wrong’.  

People seem particularly keen to find out what firebrand chef Gordon Ramsay thinks of the debacle, frantically tweeting him images of the offending dishes to get his opinion.

His thoughts remain, as yet, unknown.  

(Who gives a fuck?)

Earlier this year Australian Morgan Jane Gibbs found worldwide notoriety with a Facebook snap of a plateful of very pink pieces of chicken with the caption: ‘Just made chicken medium rare chicken strips.

‘They’re so good can’t believe I’ve never tried it like this before,’ she said. 

‘Can’t wait to dig into this with my homemade salad and veges. #healthy #newyearsresolution #clean #cleaneating’

Unsurprisingly the post has gained notoriety online as people tried to figure out if Ms Gibbs is being serious with her nauseating dish.

While the post by Ms Gibbs was most likely a joke, the image itself was of a legitimate dish, origination from a blog promoting tourism in the Japanese region of Shizuoka and the recipe for chicken tataki; chicken seared over hot coals and served raw.

Chicken sashimi is another Japanese dish where the bird is served raw, chefs manage to avoid the issue of pesky food poisoning by serving the meat as fresh as possible and raising the chickens in a hygienic environment.

That’s some microbiological poultry manure (check your organic garden).

To avoid the risk of food poisoning, the NHS recommends that chicken must be cooked through so that the meat is ‘no longer pink, the juices run clear and it’s steaming hot throughout.’ 

No wonder the UK is messed up about chicken, the government-types can’t get advice right.

Use a thermometer and stick it in.